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The Journal of Cardiovascular Surgery 1999 August;40(4):615-7

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Monofilament absorbable sutures in median sternotomy

Isik Ö., Ipek G., Mansuroglu D., Berki T., Tuzcu M., Yakut C.

From the Kosuyolu Heart and Research Hospital, Istanbul, Turkey


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Background. The ­most com­mon mate­ri­al ­used for clo­sure of ­median ster­not­o­my inci­sion is ­steel ­suture in ­open ­heart sur­gery. Some com­pli­ca­tions and dis­ad­van­tag­es ­have ­been inves­ti­gat­ed recent­ly. These com­pli­ca­tions are the break­ing ­down of ­steel ­suture, ero­sion of ster­num tab­u­lae espe­cial­ly in oste­op­o­rot­ic ­patients, ero­sion of the der­mis espe­cial­ly in ­patients ­with ­thin sub­der­mic ­layer and ­cause of infec­tion. Another dis­ad­vent­age of ­steel ­suture mate­ri­al is cos­met­ic prob­lems or dis­con­fort. For ­these rea­sons ­some ­suture mate­ri­als ­such as ­silk, poly­fil­a­ment poly­es­ter, mono­fil­a­ment mate­ri­al, poly­pro­py­lene ­have ­been ­used recent­ly. Silk and poly­es­ter ­have a ­risk of ­high infec­tion, and poly­pro­py­lene caus­es gran­u­la­tion tis­sue accord­ing to the num­ber of ­knots. These ­facts encour­aged the ­usage of an absorb­able ­suture mate­ri­al. The avail­able poly­fil­a­ment absorb­able ­sutures in the mar­ket a few ­years ago had a ­short absorp­tion ­time, caus­ing ster­nal infec­tion and dehis­cence. Polydiaxone, a mono­fil­a­ment ­suture mate­ri­al intro­duced recent­ly has a con­sid­er­ably long­er absorp­tion ­time.
Methods. 153 ster­nal clo­sures ­were per­formed ­with mono­fil­a­ment absorb­able ­suture mate­ri­al in a peri­od of sev­en ­months at the Kos¸uyolu Heart and Research Hospital. The ­mean age of the ­patients was 32.55, rang­ing ­from 8/12 to 71 ­years. The ­mean ­body ­weight is 48.37, rang­ing ­between 7 kg and 75 kg.
Results. Only two ­patients had ster­nal dehis­cence.
Conclusions. We con­clude ­that mono­fil­a­ment absorb­able ­suture is a ­safe alter­na­tive for all ­kinds of ­steel ­suture mate­ri­al for clo­sure of ster­not­o­my.

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